综合治疗降低尖锐湿疣复发率

Combined treatment to reduce recurrent rate of condyloma acuminatum

抗病毒药物伐昔洛韦 (valacicolvir)和免疫增强剂卡介苗 (BCG)等联合运用综合治疗尖锐湿疣 ,以降低尖锐湿疣的复发率。将符合标准的 117例尖锐湿疣患者 ,随机分为单纯激光组 (A组 )和综合治疗组 (B组 )。综合治疗组采用激光加术后抗病毒药伐昔洛韦口服 ,每次 30 0 mg,每日二次 ,连服 2 1d,免疫增强剂卡介苗 (BCG)穴位注射 ,每次 2 ml,隔日一次 ,共 12次 ;另在激光伤口局部用 0 .1%雷凡诺液湿敷 ,每次 15 min,并在伤口边缘外涂 5 %阿昔洛韦霜 ,每天 2～ 3次 ,直至伤口局部皮肤完全恢复正常。治疗结束后 3个月及 6个月各随访 1次 ,记录复发情况。3个月时 ,复查单纯激光组 (A组 )复发 15例 (2 4.19% ) ,综合治疗组 (B组 )复发3例 (5 .45 % ) ,两组间统计学上有显著差异 (P<0 .0 1)。 6个月时复查 ,A组复发 11例 (17.74% ) ,B组复发 1例 (1.82 % ) ,两组间仍存在显著性差异。结论 :抗病毒药伐昔洛韦加免疫增强剂卡介苗等综合治疗尖锐湿疣 ,能显著降低尖锐湿疣的复发率 。

Objective: To reduce the recurrent rate of condyloma acuminatum (CA) by valaciclovir hydrochloride and BCG etc. combined treatment.Methods: One hundred and seventeen patients with CA were randomized and divided into two groups. The patients in group A were treated by CO 2 Laser, and those in group B after operation by CO 2 Laser, followed by 0.3g valaciclovir hydrochloride orally twice a day for 21 days, and 2ml BCG inj. were injected into 'YinBao' acupuncture point every other day for twelve times, and be applied on the surface of the wound with 0.1% Liquor Rivanol for fifteen minutes every time, then be applied with 5% Cream acyclovir for twice or three times every day around the wound until healing. Results: The follow up period of 3~6 months after the patients were all cured. Results had revealed that the clinical recurrent rates of group A and group B, 24.19% and 5.45% respectively on the third month; 17.74% of group A and 1.82% of group B, on the sixth month respectively. There is statisically significant difference between them ( P <0.01). Conclusion: The combined CO 2 Laser operation with orally valaciclovir hydrochloride and also injection of BCG etc. is more effective to treat CA than CO 2 Laser operation only. The valaciclovir hydrochloride and BCG etc. combined treatment is a more effective and safe method to reduce recurrent rate of CA.